Historically, ozone was first administered by application to external body surfaces to determine its effects on a variety of lesions, A. Wolff in 1915, is credited for using local ozone treatments for wounds, fistulas, decubitus ulcers and osteomyelitis. Like natural rubber which cracks and fritters when exposed to oxygen-ozone mixtures, early materials caused ozone to "bag" around skin surfaces and met with early oxidation disuse. Today, specially designed plastics (Teflon) enable extremities or portions of the head or torso to be comfortably encased in a space where a determined dosage ratio of oxygen to ozone is administered at a chosen flow rate. In this way, the walls of the transparent bags do not touch the patient, an important consideration in burn treatment.
Indication for external ozone application include poorly healing wounds, burns, staphylococcal infections, fungal and radiation lesions, herpes simplex and zoster, and gangrene (diabetic or Clostridium). Dosage is adjusted to the condition treated. Gas perfusions may last from 3 to 20 minutes, ozone concentrations varying from 10 to 80 ug/ml (maximum five parts of ozone to 95 parts of oxygen). High ozone concentrations are used for disinfection and cleaning (or debridement), while low concentrations promote epithelialization and healing